Bifurcating Method for Subcutaneous Indwelling of Nonabsorbable Threads

Subcutaneous indwelling of nonabsorbable threads for tissue fixation and tension reduction is often used in plastic surgery and is applied in breast reduction surgery, umbilicoplasty, and in frontalis muscle lifting for congenital ptosis. However, in a few cases, exposure of the indwelling thread necessitates its removal. Exposure of the indwelling threads mostly occurs due to exposure of the knots. Therefore, we require a novel method to ensure that the knot of the indwelling thread remains unexposed. Hence, we created a stab incision to place the indwelling nonabsorbable threads ligated with moderate tensile force. Furthermore, we attached needles to each end of the ligated thread. The needles penetrated from the stab incision through the depths to separate sites farther away from each other. Finally, we towed and cut the exposed thread from the skin. Thus, the knots on the indwelling thread may be positioned deeper, reducing the risk of exposure to the indwelling thread. Furthermore, the risk of overcorrection is reduced as each end of the indwelling threads penetrates a different site. In addition, this method leaves certain length of the end of the knot under the skin, which improves the visibility of the indwelling thread during revision surgery, facilitates access, and reduces the operative time. Application of this method in subcutaneous indwelling of nonabsorbable threads may reduce complications and time required for revision surgery.